Redefining therapy for previously treated renal cell carcinoma
Mené sur 747 patients atteints d'un carcinome rénal de stade localement avancé ou métastatique (durée médiane de suivi : 29 mois), cet essai international de phase III compare l'efficacité, du point de vue de la survie sans progression et de la survie globale, et la toxicité du cabozantinib et d'un traitement combinant belzutifan et lenvatinib
For more than a decade, the question of what to offer patients with metastatic clear-cell renal cell carcinoma after front-line therapy was familiar. Treatment consisted of a VEGFR-tyrosine-kinase inhibitor, frequently sequenced after another. The framework began with the TARGET trial1 in patients with cytokine-refractory disease, and matured in the post-VEGFR-tyrosine-kinase inhibitor population through the AXIS trial,2 which showed superiority of axitinib over sorafenib, and the pivotal METEOR trial,3 which established cabozantinib as a second-line standard of care. The randomised, phase 2 trial of lenvatinib plus everolimus brought doublet therapy into practice, although its modest size and design limited the strength of the evidence.4 Each of these studies, however, enrolled patients pretreated with cytokines or earlier-generation VEGFR-tyrosine-kinase inhibitors, a population fundamentally different from the patients we treat today who receive immunotherapy combinations.
The Lancet , commentaire, 2026